International journal of pediatric otorhinolaryngology最新文献

{"title":"Steroid use after pediatric tonsillectomy: A systematic review and meta-analysis","authors":"Elizabeth M. Puyo ,&nbsp;Jillian L. Chen ,&nbsp;Rahul Mullick ,&nbsp;Jessica R. Levi","doi":"10.1016/j.ijporl.2025.112584","DOIUrl":"10.1016/j.ijporl.2025.112584","url":null,"abstract":"<div><h3>Objective</h3><div>Codeine-containing products for postoperative pain in pediatric adenotonsillectomy were contraindicated in 2013, prompting a search for alternative analgesic methods. This systematic review examines whether postoperative steroids improve clinical outcomes – specifically pain, nausea, vomiting, and postoperative hemorrhage – in pediatric patients following tonsillectomy.</div></div><div><h3>Data sources</h3><div>Comprehensive literature review (MEDLINE/PubMed, Cochrane Library, Embase) of studies conducted internationally between February 20, 2013, and December 5, 2024.</div></div><div><h3>Methods</h3><div>A comprehensive literature search of PubMed/MEDLINE, Cochrane Library, and Embase was conducted for studies published between February 20, 2013 and December 5, 2024. Included studies were randomized controlled trials, cohort studies, and observational studies evaluating postoperative steroid use in pediatric tonsillectomy patients with reported outcomes of pain, nausea, vomiting, or hemorrhage. Extracted data included steroid type, dosage, timing, and primary outcomes. A random-effects model was used to calculate pooled risk ratios for postoperative hemorrhage.</div></div><div><h3>Results</h3><div>Eight studies, reporting on 4598 patients, met inclusion criteria. The studies exhibited heterogeneity in steroid type, dose, and timing. Pain outcomes varied, with three of five studies reporting significant reductions at specific postoperative time points. Pooled analysis of postoperative hemorrhage rates revealed no significant reduction (RR 0.88, 95 % CI 0.55–1.41, p = 0.60). Three studies evaluated nausea and vomiting; one reported significant reduction, while the other two showed no difference.</div></div><div><h3>Conclusions</h3><div>While postoperative steroids may reduce pain and possibly alleviate nausea and vomiting after pediatric tonsillectomy, current evidence is limited and inconsistent due to study heterogeneity. Steroids do not appear to significantly affect postoperative hemorrhage rates. Further research is needed to clarify their role in recovery.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"198 ","pages":"Article 112584"},"PeriodicalIF":1.3,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic accuracy of laryngeal ultrasound in the evaluation of stridor at a tertiary care pediatric center in India","authors":"Sahiti Nori ,&nbsp;Prem Kumar P. ,&nbsp;Afshan Fathima ,&nbsp;Sanjay K. S. ,&nbsp;Manu Srinivas H. ,&nbsp;Usha Palakshan","doi":"10.1016/j.ijporl.2025.112597","DOIUrl":"10.1016/j.ijporl.2025.112597","url":null,"abstract":"<div><h3>Background</h3><div>Pediatric airway assessment with endoscopy puts forth certain challenges. Laryngeal Ultrasound (LUS) is a non-invasive imaging modality that enables evaluation of laryngeal dynamics. This study aims to assess the clinical utility and diagnostic accuracy of LUS in diagnosing pediatric stridor by comparing its findings with endoscopic assessment.</div></div><div><h3>Methodology</h3><div>This prospective blinded cohort study included patients aged between 0 and 17 years, presenting with stridor. Those previously diagnosed were excluded. All patients were subjected to a Laryngeal Ultrasound followed by a Microlaryngoscopy and Bronchoscopy (MLB). Sensitivity, specificity, and positive and negative predictive values for LUS were calculated compared to the gold standard.</div></div><div><h3>Results</h3><div>We describe 26 patients with stridor, with a median age of 4 months. LUS was able to correctly identify 21/26 cases (80.76 %), with the most common cause being laryngomalacia in 11/26 cases (42.3 %). Other pathologies identified were subglottic stenosis, vocal fold palsies, vallecular cysts, and glottic masses (papilloma). The overall diagnostic accuracy of laryngeal ultrasound in identifying the cause of pediatric stridor was calculated and sensitivity was found to be 78.26 % (95 % CI: 56.3–92.54 %), specificity 100 % (95 % CI: 29.24–100 %), positive predictive value 100 % (95 % CI: 81.47–100 %) and negative predictive value 37.5 % (95 % CI: 21.65–56.58 %).</div></div><div><h3>Conclusion</h3><div>Laryngeal Ultrasound can increasingly be used as a first-line, non-invasive airway assessment tool that can be repeated at the bedside for screening purposes. Our study found a high specificity and positive predictive value for Laryngeal Ultrasound in diagnosing Pediatric stridor. Its routine use to assess the pediatric larynx could potentially help in the selection of stridulous children for MLB.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"198 ","pages":"Article 112597"},"PeriodicalIF":1.3,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145300804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnosis and management of postcricoid cushion in infants: A single-center experience","authors":"Xiaowei Chen ,&nbsp;Feizhou Zhang ,&nbsp;Li Yang ,&nbsp;Fang Jin ,&nbsp;Hujun Wu ,&nbsp;Xiaofen Tao ,&nbsp;Lei Wu ,&nbsp;Lanfang Tang","doi":"10.1016/j.ijporl.2025.112590","DOIUrl":"10.1016/j.ijporl.2025.112590","url":null,"abstract":"<div><h3>Objective</h3><div>Postcricoid lesions in children encompass a diverse range of pathological alterations in the posterior cricoid area, involving the posterior pharyngeal wall, postcricoid mucosa, and adjacent soft tissues. These lesions can notably affect respiratory and swallowing functions, predominantly affecting infants and preschool-aged children.</div></div><div><h3>Methods</h3><div>A retrospective analysis was carried out on the clinical manifestations, diagnosis, treatment modalities, and prognosis of children diagnosed with postcricoid cushion admitted to our hospital from June 2020 to June 2025.</div></div><div><h3>Results</h3><div>Over a five-year period, our center managed 33 cases of children with postcricoid cushion. Among them, 23 cases were male (23/33) and 10 cases were female (10/33). The youngest patient was diagnosed immediately after birth, while the oldest was 4 years old, with a median age of 6.84 months. Laryngeal stridor and abnormal throat sounds were the primary reasons for patients seeking medical attention, with only two patients reporting feeding difficulties and milk choking. 10 cases underwent neck CT angiography (CTA) and 8 cases had magnetic resonance imaging (MRI). In both CTA and MRI results, the predominant local soft tissue thickening of the posterior pharyngeal wall was a frequently observed finding. Laryngomalacia emerged as the most prevalent comorbid laryngeal abnormality. Notably, among the ten children treated with propranolol, not even one demonstrated a significant therapeutic response.</div></div><div><h3>Conclusion</h3><div>The postcricoid cushion, a normal anatomical entity, warrants heightened attention from pediatricians. In most infants, laryngeal stridor or abnormal phonic emissions should elicit concerted vigilance among parents and clinicians. Given that laryngeal imaging modalities typically fail to characterize lesion, laryngoscopy remains paramount for establishing a definitive diagnosis, whereas specific interventions are generally unnecessary. Notably, the inefficacy of empirical β-blocker therapy (e.g., propranolol) underscores the imperative for systematic re-evaluation of diagnostic approaches to mitigate misdiagnosis risks.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"198 ","pages":"Article 112590"},"PeriodicalIF":1.3,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145267416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgical burden in pediatric patients undergoing double-stage laryngotracheal reconstruction: A retrospective analysis","authors":"Zialesi W. Adissem ,&nbsp;Megan McNutt ,&nbsp;Natalie Quinn ,&nbsp;Michael Boutros ,&nbsp;Kevin Liu ,&nbsp;Isaac Kistler ,&nbsp;Ashley Miller ,&nbsp;Tendy Chiang","doi":"10.1016/j.ijporl.2025.112592","DOIUrl":"10.1016/j.ijporl.2025.112592","url":null,"abstract":"","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"198 ","pages":"Article 112592"},"PeriodicalIF":1.3,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145329172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative antibiotic ear drops in pediatric tympanostomy tubes: applying statement 13 of the 2022 clinical practice guidelines","authors":"Sofia Piperno ,&nbsp;Zachary S. Burgess ,&nbsp;Brian J. McKinnon ,&nbsp;Yusif Hajiyev ,&nbsp;Charles A. Hughes ,&nbsp;Harold S. Pine","doi":"10.1016/j.ijporl.2025.112594","DOIUrl":"10.1016/j.ijporl.2025.112594","url":null,"abstract":"","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"198 ","pages":"Article 112594"},"PeriodicalIF":1.3,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rethinking drain protocols in pediatric thyroidectomy","authors":"Kaitlyn Zenner ,&nbsp;Ashley L. Soaper ,&nbsp;Charles M. Myer IV ,&nbsp;Michael J. Rutter ,&nbsp;Matthew M. Smith","doi":"10.1016/j.ijporl.2025.112596","DOIUrl":"10.1016/j.ijporl.2025.112596","url":null,"abstract":"<div><h3>Introduction</h3><div>Pediatric thyroidectomy is an uncommon procedure performed for many diagnoses. Literature from adult populations suggests drain use following thyroidectomy does not alter hematoma or seroma risk and may increase infection risk, however this has not been explored in the pediatric population. The objective of this study was to determine if drain use altered risk of postoperative complication in pediatric thyroidectomy patients.</div></div><div><h3>Methods</h3><div>We conducted a retrospective case series examining individuals under 21 years of age who underwent thyroidectomy with or without central (CND) or lateral neck dissection (LND) for any indication between July 2011 and October 2024 at a tertiary children's hospital. The primary measured outcome was relative risk of complication comparing drain or no drain following thyroidectomy.</div></div><div><h3>Results</h3><div>Two hundred eighty-nine individuals underwent 310 procedures. Drains were placed in 95/277 (34.2 %) total thyroidectomies without neck dissections. Drains were placed in 15/16 (94 %) thyroidectomies with LND±CND and 9/17 (52.9 %) thyroidectomies with only CND. No complication was seen following neck dissection. No hematomas occurred with a drain and one occurred without a drain. Three infections occurred, one with a drain and two without. One seroma occurred with a drain. The relative risk of complication following thyroidectomy without neck dissection and no drain was 0.78 (95 % CI: 0.13, 4.61).</div></div><div><h3>Discussion</h3><div>Post thyroidectomy complications are rare and the decision to forgo drain placement did not increase risk of complication in a pediatric cohort. No complications were seen with CND regardless of drain status suggesting drains may not be necessary in this population.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"198 ","pages":"Article 112596"},"PeriodicalIF":1.3,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying the utility of a ‘second look’ for detecting occult bleeding in pediatric tonsillectomy","authors":"Alexandra F. Corbin ,&nbsp;David A. Riccio ,&nbsp;Jeremy Walsh ,&nbsp;Jacob Fried ,&nbsp;Michele M. Carr","doi":"10.1016/j.ijporl.2025.112598","DOIUrl":"10.1016/j.ijporl.2025.112598","url":null,"abstract":"<div><h3>Objective</h3><div>Quantify the intraoperative utility of a standardized ‘second look’ assessment following initial hemostasis in pediatric tonsillectomy procedures.</div></div><div><h3>Design</h3><div>Retrospective observational study.</div></div><div><h3>Setting</h3><div>Single tertiary care children's hospital between February and August 2023.</div></div><div><h3>Participants</h3><div>Children aged 2–18 years who underwent tonsillectomy with or without adenoidectomy.</div></div><div><h3>Outcome measures</h3><div>Following completion of surgery and initial hemostasis, the mouth gag was relaxed for 1 min, after which a standardized ‘second look’ examination of the tonsillar fossae was performed. The primary outcome was the need for additional cautery during the ‘second look’ phase.</div></div><div><h3>Results</h3><div>A total of 126 children were included with a mean age of 5.8 ± 0.5 years. Obstructive symptoms were the primary surgical indication (<em>n</em> = 107, 84.9 %). Procedures were performed by otolaryngology attendings (<em>n</em> = 64, 50.8 %), otolaryngology residents (<em>n</em> = 57, 45.2 %), or collaboratively (<em>n</em> = 5, 4.0 %). Suction cautery was the predominant hemostasis method (<em>n</em> = 115, 91.3 %), with alternative methods used in the remaining cases (<em>n</em> = 11, 8.7 %). Cautery was required during the ‘second look’ phase in 92 cases (73.0 %). No significant associations were found between additional cautery usage and procedure type, patient age, surgical indication, surgeon training level, or hemostasis method.</div></div><div><h3>Conclusion</h3><div>The high frequency of additional cautery during the ‘second look’ phase demonstrates that occult intraoperative bleeding is common and may otherwise go undetected, supporting the utility of incorporating this brief reassessment step prior to case completion.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"198 ","pages":"Article 112598"},"PeriodicalIF":1.3,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292304","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pediatric necrotizing soft tissue infections of the head and Neck: A case report and systematic review","authors":"Carlos Khalil ,&nbsp;Jenny Xiao ,&nbsp;Eduardo Gus ,&nbsp;Evan J. Propst ,&nbsp;Nikolaus E. Wolter ,&nbsp;Jennifer M. Siu","doi":"10.1016/j.ijporl.2025.112586","DOIUrl":"10.1016/j.ijporl.2025.112586","url":null,"abstract":"<div><h3>Introduction</h3><div>Pediatric necrotizing soft tissue infection (NSTI) of the head and neck is a rare (0.08 per 100,000 children per year) but life-threatening condition requiring prompt diagnosis and treatment. This systematic review aims to describe a case report and synthesize the current literature to identify key clinical features, management strategies, and outcomes of this rare condition.</div></div><div><h3>Methods</h3><div>Medline (Ovid), Embase, the Cochrane library, and Web of Science were searched for articles that described pediatric patients who had NSTI of the head and neck. Data on patient factors, microbiology, treatment, and outcomes were extracted.</div></div><div><h3>Results</h3><div>56 cases of pediatric NSTI of the head and neck were identified from 47 articles. Mean age of occurrence was 5.2 ± 5.3 years (61 % male). Mean time to presentation was 3.2 ± 4.4 days. Most common initial presenting symptoms included overlying skin erythema (n = 37/56, 66 %), edema (n = 36/56, 64 %), fever (n = 31/56, 55 %), pain (n = 19/56, 34 %), tachycardia (n = 16/56, 29 %), hypotension (n = 15/56, 27 %), and skin necrosis (n = 8/56, 14 %). Anatomical location of head and neck NSTI involvement was most commonly reported in cervicofacial (45/56, 80 %), craniocervical (8/56, 14 %), and thoracocervical (7/56, 13 %). Of known aetiologies, the most frequently reported were traumatic/iatrogenic (n = 11/56, 20 %) and odontogenic (n = 7/56, 13 %). In 41 % of cases the etiology of NSTI was unknown (23/56). Imaging was performed prior to the initial OR in 59 % of cases (n = 33/56) and computed tomography (CT) was the most common imaging modality (43 %, 24/56). Mean time to first surgical debridement was 1.3 ± 3.4 days. The most frequently identified microorganism was <em>Group A Streptococcus</em> (n = 13/56, 23 %), polymicrobial (n = 11, 20 %), <em>Staphylococcus</em> (n = 6/56, 11 %), and <em>Pseudomonas</em> (n = 6/56, 11 %). Almost one half (n = 19/41, 46 %) of the cases required more than one surgical debridement, and the overall average number of debridements was 2.3 ± 2.0. Mean length of hospital stay was 30 ± 25 days and overall mortality was 5 % (3/56).</div></div><div><h3>Conclusion</h3><div>Pediatric NSTI of the head and neck is a rare, life-threatening condition requiring early recognition and aggressive management. Prompt diagnosis, timely surgical debridement, and a multidisciplinary approach are critical to improving outcomes in this vulnerable population.</div></div>","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"198 ","pages":"Article 112586"},"PeriodicalIF":1.3,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145300813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes and surgical management of pediatric sympathetic chain tumors: A scoping review and case-series","authors":"Barak M. Spector ,&nbsp;William Cohen ,&nbsp;Kristen Mathew ,&nbsp;Zachary Pierre ,&nbsp;Ryan Belcher","doi":"10.1016/j.ijporl.2025.112588","DOIUrl":"10.1016/j.ijporl.2025.112588","url":null,"abstract":"","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"198 ","pages":"Article 112588"},"PeriodicalIF":1.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145251255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visual short-term memory skills in children using cochlear implant and typically developing children- a comparative study","authors":"Shweta Deshpande,&nbsp;C.S. Vanaja","doi":"10.1016/j.ijporl.2025.112591","DOIUrl":"10.1016/j.ijporl.2025.112591","url":null,"abstract":"","PeriodicalId":14388,"journal":{"name":"International journal of pediatric otorhinolaryngology","volume":"198 ","pages":"Article 112591"},"PeriodicalIF":1.3,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258090","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}